What does a neurologist do?
A neurologist is a medical provider who diagnoses and treats nervous system disorders and injuries. These include conditions affecting the brain, spine, and nerves. Your primary care doctor (PCP) will refer you to a neurologist for symptoms such as memory loss, headaches, imbalance, numbness, pain, and muscle weakness.
A general session with a neurologist begins with diagnosing the condition by understanding the patient's medical history, family history, and symptoms. They also perform a physical and neurological evaluation and order specific diagnostic tests during such an appointment. Subsequently, they devise a treatment plan, including non-surgical modalities such as medications, radiation, rehabilitation, nerve stimulation, pain management, and lifestyle changes. They will make a referral to a neurosurgeon if surgical intervention is necessary.
What conditions does a neurologist treat?
Neurologists can treat more than 600 types of neurological disorders. Some of the most common ones include:
- Alzheimer's disease: It progressively causes memory loss, cognitive decline, and behavioral changes.
- Parkinson's disease: It affects movement, causing tremors, rigidity, and difficulty with walking and coordination.
- Multiple sclerosis is an autoimmune ailment that causes nerve damage, leading to symptoms such as vision loss, chronic pain, fatigue, and impaired coordination.
- Amyotrophic lateral sclerosis (ALS) affects the nerve cells in the body, causing muscle weakness, muscle loss, and a decline in physical function.
- Meningitis: It is an inflammation of the brain and spinal cord membranes, leading to symptoms such as headache, fever, and stiff neck.
- Epilepsy: It occurs when the brain nerve cell activity is disturbed and causes symptoms such as seizures, unusual behaviors, and unconsciousness.
- Stroke is brain damage caused by inadequate blood circulation to the brain's different parts.
- Migraine headaches: These cause intense throbbing pain on one side of the head, nausea, and light sensitivity.
- Essential tremors: They are characterized by involuntary and rhythmic shaking of the hands, head, voice, or other body parts, often worsening with age.
- Tumors of the brain, spine, and nerves: These refer to abnormal growths or masses in the tissues of the nervous system, which can be benign or cancerous.
Medical tests conducted by neurologists
When you visit a neurologist near you, they may perform different tests and procedures to diagnose and treat neurological conditions. Some standard neurologic tests include the following:
- Angiography: This test can display abnormal, damaged, or blocked blood vessels in the brain, head, or neck. Neurologists use it to detect health issues like blood clots or aneurysms.
- Cerebrospinal fluid analysis: Neurologists perform the test by removing a sample of fluid surrounding the brain and spinal cord. They study it to detect evidence of metabolic diseases, multiple sclerosis, infections, and brain bleeds.
- Computed tomography (CT or CAT scan): This test uses computer imaging technology and X-rays to obtain detailed images of the inside of the body. It helps identify abnormalities in the brain.
- Electroencephalography (EEG): Neurologists conduct the EEG test to measure and record the brain’s electrical activity. It helps them identify abnormal electrical activities and diagnose conditions like brain tumors, comas, infections, and seizures.
- Electromyography (EMG): The EMG test assesses how a patient’s muscles respond to electrical stimulation from motor neurons. It helps neurologists diagnose spinal nerve root compression, muscle and nerve disorders, and motor neuron disorders.
- Lumbar puncture: Neurologists use a lumbar puncture to collect a spinal fluid sample from a patient’s back. This helps them check and identify various health issues, such as bleeding in the brain, dementia, leukemia, inflammation of the spinal cord, and autoimmune diseases like MS. They can also use the lumbar puncture to treat conditions by injecting antibiotics or anesthetics or performing cancer treatments.
What is an essential tremor?
An essential tremor (ET) is a neurological condition that produces uncontrollable shaking in various areas on opposing body sides. Hands, arms, head, larynx (voice box), tongue, and chin are frequently affected by this condition, while the lower body rarely gets impacted. People with ET can lead everyday lives, but they may struggle to eat, dress, or write independently. Tremors can also become incapacitating only when they get intense.
Neurologists first review your medical history and understand your symptoms if ET is suspected. Subsequently, if diagnosed, treatment varies from patient to patient, as per individual conditions. It may also include surgical interventions that can help with phasing out dependence on tremor medication or expediting treatment.
Typically, the following surgical procedures can help with ET:
- Focused ultrasound using MR guidance
- Deep brain stimulation (DBS) in the thalamus (chronic thalamic stimulation)
- Stereotactic thalamotomy
Diagnosing ET: Neurologists usually diagnose ET through reports of a movement disorder, other symptoms, and a complete neurological evaluation. ET can be identified without specific blood, urine, or other tests. It is vital to remember that not all tremors are due to ET. Some may be a result of thyroid disease, too much caffeine, or pharmaceutical side effects.
Generally, one may have ET if they experience the following symptoms:
- Uncontrollable shaking lasting for a few seconds
- Trembling voice
- Head nods
- Tremors that get worse during a lot of stress
- Tremors that get worse as you move
- Balance issues (in some rare conditions)
Medications for ET: If the symptoms of ET are moderate, some patients may not need treatment. However, if the symptoms exacerbate, your doctor may prescribe certain drugs, such as:
- Beta-blocking drugs: Beta-blockers, like propranolol (Inderal, InnoPran XL, Hemangeol), commonly treat high blood pressure and help reduce tremors in certain people. Beta-blockers may not be a choice if you have asthma or specific heart issues. Fatigue, lightheadedness, and cardiac difficulties are all probable side effects.
- Anti-epileptic drugs: People who don't respond to beta-blockers may benefit from epilepsy medicines. These may include primidone (Mysoline). Gabapentin (Gralise, Neurontin, Horizant) and topiramate are two more drugs that may be administered (Topamax, Qudexy XR, others). Drowsiness and nausea are common side effects of these medicines, but they usually disappear quickly.
- Tranquilizers: Doctors use benzodiazepine drugs like clonazepam (Klonopin) to treat people whose tremors get worse due to anxiety or stress. Fatigue or moderate sedation are possible side effects of such medications. One should use these drugs with caution since they can become addictive.
- OnabotulinumtoxinA (Botox) injections: Some types of tremors, particularly head and vocal ones, may benefit from Botox injections, which help with tremors for around three months. However, when Botox treats hand tremors, it might cause finger weakness. When Botox treats voice tremors, it results in a hoarse voice and swallowing difficulties.
Apart from the abovementioned medications, patients can also benefit from different types of therapy. For example, physical therapists can teach exercises that develop muscle strength, control, and coordination. Occupational therapists can also assist patients in adjusting to ET. They may recommend adaptive equipment to help you cope with the effects of tremors in your daily life, such as:
- Heavy glasses and utensils
- Weighted wristbands
- More comprehensive and relatively heavier writing tools, such as wide-grip pens
Other effects of ET: This condition can lead to different disorders, including movement-related diseases like Parkinson's. Patients affected by ET are also at a high risk of dementia (especially Alzheimer's). ET medications may increase one's chances of becoming depressed.
Dietary changes that can help with ET: Many culturally oriented diets will likely affect health synergistically. The Mediterranean diet, for example, consists of various foods, each of which is healthy. These are:
- Fruits, vegetables, and legumes
- Fish
- Cereals (ideally whole grain)
- Monounsaturated fatty acids
It also contains low dairy, meat, and poultry intake and moderate to low alcohol consumption, which can both be helpful for ET patients.
The Mediterranean diet (MeDi) can improve cardiovascular health, decrease inflammation, and protect against oxidative degradation when followed consistently over time. Adults who follow MeDi also have a lesser chance of Alzheimer's disease.
Can neurologists treat mental health conditions?
As mentioned earlier, neurologists are specialized medical professionals. They can expertly diagnose and treat conditions limited to those that affect the physical parts of the nervous system, such as concussions or seizures. These may be due to structural damage or specific diseases.
However, a neurologist's expertise does not extend to mental health conditions like depression. These conditions result from brain chemicals or functioning and are outside the purview of a neurologist's skillset. If such an issue arises, patients are referred to a neuropsychologist - a healthcare specialist who studies the relationship between the brain and one's actions and treats how the brain influences one's daily life. Neuropsychologists can help patients manage any condition through strategy and intervention but cannot prescribe medications.
Regardless, it is crucial to discuss your mental health with a neurologist, as some disorders can mimic neurological conditions. For instance, depression can cause unexplained memory difficulties. Thus, communicating with your neurologist about your mental health is essential for the maintenance of overall brain health and receiving accurate diagnosis and treatment.
How should one prepare for their first neurologist appointment?
First visits to a healthcare practitioner can be daunting. However, following some simple tips to prepare before your appointment can help you make the most of your visit with the best neurologist near you.
You can get ready for your session by adopting the following steps:
- Create and carry a list of the most pressing issues you wish to discuss with your neurologist.
- Inform your neurologist of any changes in your overall health.
- Share any new symptoms or changes in existing or past symptoms. Keeping a symptom diary can be of great help. You should record the date, time, duration, severity, triggers, symptoms, and the actions taken to alleviate the event. This is especially useful if you experience intermittent symptoms due to a particular condition, such as headaches, epilepsy, sleep apnea, or Parkinson's disease.
- Bring copies of test results, including laboratory work reports ordered by other healthcare providers outside your neurologist's healthcare network.
- Preparing a comprehensive record of all the medications you are presently using, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products, is highly recommended. It is also advised to inform your neurologist about prior medications that proved ineffective or had undesired outcomes.
- Provide a list of your known allergies.
- Having a friend or family member accompany you to your appointment may be helpful. They can take notes, help you understand your neurologist's explanations, ask questions, and remind you about scheduling tests and follow-up appointments. Having an extra set of eyes and ears can make the process easier and less stressful.
- Inquire whether you should schedule another appointment to discuss any additional concerns.
How to find the best neurologists near you in Pittsburgh, PA?
Neurological issues need immediate attention to avoid exacerbation. However, finding suitable practitioners can be difficult. Worry not; Zocdoc is here to help you search for and find the best-rated neurologists. Our platform offers an easy and quick way to access the bios of the top neurologists in Pittsburgh. Select your location, time, and insurance, and you will be directed to a list of the best neurologists.
Moreover, you can get filtered results of providers who accept your insurance by updating your Zocdoc account's insurance information. Smartphone users can directly upload a picture of their insurance card on the Zocdoc app to get refined results. Check out Zocdoc's patient help center for more insurance-related FAQs.
Before you make an appointment, you can view a practitioner's profile to learn about their education, experience, specialty, and patient reviews, which will help you make the best decision for your medical needs. You can also learn about their awards and accreditations, whether or not they treat children, the languages they speak, etc. Moreover, Zocdoc also enables you to book appointments on weekends and after 5 PM, along with video consultations for specific practitioners.
Thus, using Zocdoc, all appointment bookings with the best neurologist near you become fast, free, and secure.
ET and Alzheimer's in the US
According to the International Essential Tremor Foundation, about 10 million people in the United States have ET. Parkinson's disease, another tremor illness, is predicted to affect nearly 0.5 to 1 million persons in the United States or approximately 0.15 to 0.3% of the population. ET has high healthcare costs. A study found that roughly 25% of all ET patients are compelled to change employment or retire early because of tremors.
Around 280,000 people over the age of 65 have Alzheimer's in Pennsylvania. In addition, about 9.6% of people aged 45 and older have cognitive decline. The value of unpaid care for Alzheimer's is estimated to be around $10 billion, and the cost to the state Medicaid program is nearly $3.7 billion.
Sources
WebMD
Mayo Clinic
Sperling Medical Group
National Library of Medicine
Alzheimer's Association
Healthline
Cleveland Clinic[1]
Cleveland Clinic[2]
Medical News Today
Cedars-Sinai
Banner Health
